Fellow occupational therapists! Barbara Hellman, MOT, OTR/L and her daughter* invented a product that makes car seat buckles easy (for grandparents, parents with hand weakness etc.) They are now a TOP 8 finalist for a $5K Grant and need your vote to help them win.
The contest ends on this Tuesday July 16th, so please take a moment to support a fellow therapist and vote for UnbuckleMe.
Vote here: https://themamaladder.
Barbara’s daughter and business partner Rebecca Davison* is the Mom Entrepreneur listed (scroll down to find her name & UnbuckleMe).
Thank you so much! The support from the therapy community is greatly appreciated, and it is perfectly okay to vote from more than one device until July 16th.
UnbuckleMe is the award-winning solution for parents or grandparents who struggle to unbuckle kids’ car seat buckles (commonly due to arthritis, carpal tunnel syndrome, de Quervain’s or other hand/wrist conditions).
Barbara Hellman, MOT, OTR/L and her daughter Becca are eager to share UnbuckleMe with people who need it. Use promo code OTLOVE to save 15% off purchases on the website.
They also work with private clinics and practitioners across the country and sell wholesale with a minimum 6 piece order.
Here’s a great video of the product in action: https://youtu.be/
5yXB76HvVmoNeed some inspiration? Read this blog and get inspired on how they brought this product to market!Feel free to reach out to Barbara directly at email@example.com to learn more.
This week, UnitedHealthcare (UHC) announced a pilot program in 5 states that will waive the cost of copays and deductibles for 3 physical therapy sessions for patients with low back pain (LBP) living in Connecticut, Florida, Georgia, North Carolina, and New York. The pilot, which could affect as many as 1 million enrollees, goes into effect July 1, 2019. Other states will join the program in 2020 and 2021.
Specifically, the pilot will be available to UHC enrollees with new onset of LBP when receiving care from an outpatient in-network provider. This benefit change will not extend the enrollee’s physical therapy or chiropractic benefit maximum, and will apply only to services related to treating back pain. Enrollees must have physical therapy or chiropractic benefits remaining in order to use this benefit.
UHC will send emails about the benefit change on a quarterly basis to enrollees in the 5 states as they gain access to the benefit. Information also will be included on myuhc.com in the enrollee’s benefit information under Rehabilitation Services – Outpatient Therapy and Chiropractic (Manipulative) Treatment.
This pilot follows a multiyear collaboration between APTA, OptumLabs, and UHC that included publication of a study in the American Journal of Managed Care (subscription required). This study affirms that higher copays and payer restrictions on provider access may steer patients away from more conservative treatments for LBP, including physical therapy and chiropractic services. “Innovative modifications to insurance benefits,” authors write, “offer an opportunity for increased alignment with clinical practice guidelines and greater value.”
“This type of collaboration between a professional association and a private insurer is key to advancing the essential role of the physical therapy profession in improving outcomes for patients,” says Carmen Elliott, MS, APTA’s vice president of payment and practice management. “APTA continues to advocate for benefit design that is validated by data and meets the needs of patients, providers, and payers.” For additional info
Here’s my two cents... Having been in the industry for long enough to to remember the days when providers worried that insurers would not honor negotiated reimbursement rates, while insurers were concerned that providers would find loopholes to augment the claims they submitted, I am always happy when I read of insurer-provider alliances. I do think this program is a step in the right direction. On the other hand, while the APTA was talking with UHC, I wish they would have discussed how this insurance company has devalued the profession, and has adopted a LOW flat fee methodology for its in network providers that does not factor in the amount of time a therapist spends with a patient. UHC also has a history of audits using a “Recovery Services” team who aggressively try to classify therapy services either as medically unnecessary, or retroactively deny payment, and often demand refunds because documentations submitted in audits ” did not support” payment or meet their standards. For certain practices, especially those OON, I have never seen a more aggressive attempt to classify services that were rendered in the good faith that they would be paid for as “overpayments” with refunds demanded or taken from future payments. These are not simply “first world problems’ of physical therapists; they strike at the core of why more and more practices opt out rather than in with carriers like United Health Care. Addressing these core issues could help all patients, not just those with LBP and really help increase a patient’s access to physical therapy.
Reprinted from the NY Times March 15th 2019 –
When Don Cue developed a bladder infection last fall, he called his longtime urologist’s office for a urine culture and antibiotics. It was a familiar routine for the two-time prostate cancer survivor; infections were not uncommon since he began using a catheter that connects to his bladder through an incision in his abdomen.
When Mr. Cue called this time, a receptionist told him that his physician, Dr. Mark Kellerman, no longer worked at the Iowa Clinic in Des Moines, a large multi-specialty group. She refused to divulge where he had gone.
“As a patient, ‘scared’ is too strong a word, but my feeling is, ‘What do I do now?’” said Mr. Cue, 58.
Flummoxed, he solved his immediate problem by taking leftover antibiotics he had in his medicine cabinet.
It was only later that he learned his doctor had been fired by the Iowa Clinic and planned to start a urology practice with clinic colleagues. And, under the terms of their contract with their former employer, the doctors were banned for a year from practicing within 35 miles of the clinic, and from recruiting former patients to follow them.
Contracts with so-called restrictive covenants are now common in medicine, although some states limit their use. Noncompete clauses — common in many commercial sectors — aim to stop physicians and other health care professionals from taking patients with them if they move to a competing practice nearby or start their own. But what may be good for business can be bad for patient care — and certainly disquieting for those whose doctors seem to simply disappear.
One survey of nearly 2,000 primary care physicians in five states found that roughly 45 percent were bound by such clauses.
Continuity of care is important, doctors say, especially for patients with ongoing medical issues. Cutting off access to a doctor is different from disrupting someone’s relationship with a favorite hairstylist or money manager, they say.
“When doctors want to move from one practice to another, if they’ve got good therapeutic relationships with their patients, you’d think that public policy would want them to continue to treat these patients that trust them,” said Judy Conti, government affairs director at the National Employment Law Project.
Here is the contact info to let your concerns be known:
12th Judicial District
Regents Office, State Education Building, 89 Washington Avenue, Albany, N.Y. 12234
7th Judicial District
925 Crossroads Building, Two State Street, Rochester, NY 14614
Commissioner of Education and
President of the University of the State of New York
P-12 Instructional Support
Assistant Commissioner Special Education
On December 26th, the New York State Workers’ Compensation Board adopted regulations which substantially increase payment for PT and OT therapy services provided to injured workers effective April 1, 2019.
The conversion factor for PT and OT services increased from 21 to 30 percent across the 4 regions of the state. The average conversion factor increase across all 4 regions was 25.4%
Initial evaluations are capped at 18 RVUs, revaluations are capped at 15 RVUs and follow up visits are capped at 12 RVUs, all of which allow for a greater intensity/duration of medically necessary treatment to be provided per session.
The changes in the fee schedule will take effect April 1, 2019.
There is NO hard cap of 12 visits/180 days.
I will post additional information as I find it out.
Reprinted from the NYTimes August 20 2018. By Dr. Perri Klass, MD
Doctors should prescribe playtime for young children, the American Academy of Pediatrics says.
The most famous painting of children at play is “Children’s Games,” the 1560 work by Pieter Bruegel the Elder of a town square in which children from toddlers to adolescents (scholars have counted 246) are playing a range of timeless games. There are dolls and marbles and tiddlywinks, ball games and climbing games and riding games (scholars have counted 90 or so). The children are the only ones in town, and their activities offer a kind of taxonomy of play.
But some worry that our current culture is less friendly to play, and that children may not be getting the chance to explore all its possibilities. To try to address that, the American Academy of Pediatrics released a policy statement on Monday titled “The Power of Play: A Pediatric Role in Enhancing Development in Young Children.”
The statement characterizes play as intrinsically motivated, involving active engagement and resulting in “joyful discovery.” It summarizes extensive developmental and neurological research on play, and tries to tease out some of the specific developmental discoveries in peek-a-boo (repetitive games provide “the joy of being able to predict what is going to happen”) and Simon Says (builds impulse control and executive function). It also says that doctors should encourage playful learning for parents and infants by writing a “prescription for play” at every well-child visit in the first two years of life.
It’s a values statement because many who study play feel that it is under siege, even as new research emphasizes its importance in children’s development.
We’re in a climate where parents are feeling like they need to schedule every minute of structured time, and 30 percent of kindergartens offer no recess,” said Dr. Michael Yogman, chairman of the A.A.P. committee on psychosocial aspects of child family health and the lead author of the statement. To some, he said, “play is seen as irrelevant and old-fashioned.”
Dr. Benard Dreyer, the director of developmental and behavioral pediatrics at New York University School of Medicine and a past president of the American Academy of Pediatrics, said, “The old saying is, play is the work of children. Play is the way they learn and the way they develop. It’s important to understand how all of us, and especially parents, can encourage play.” “Kids develop 21st-century skills in play,” said Dr. Yogman, who is chief of the division of ambulatory pediatrics at Mount Auburn Hospital in Cambridge, Mass. These include social and emotional skills and executive function, “skills that are crucial for adults in the new economy, that help them collaborate and innovate.”
A fundamental job in pediatric primary care is to strengthen the parent-child relationship, he said, and play is important in that area as well. Even with a very young child, he said: “When a 3-month-old smiles and a parent smiles back, those kinds of turn-taking activities are not only far from trivial,” but are actually important for developing language and social-emotional skills, such as taking turns.
The stable relationships with parents and other caregivers that are built through these interactions are also important for helping children navigate stress and trauma and preventing what we have come to call “toxic stress” from damaging the child’s development.
California PT OT and STs – the California Supreme Court issued a decision April 30th which results in new legal standard for determining whether a worker is an independent contractor or an employee. This is a major development in California employment law that will cause many workers now classified as independent contractors to be considered employees in the eyes of the state.
Under the Court’s new “ABC” test, a worker is presumptively considered an employee under the California Wage Orders unless the employer can establish all of the following three elements:
- The worker is free from the direction and control of the person who hires him/her in connection with the performance of the work, both under the contract for the work and in fact;
- The worker performs work that is outside the usual course of the hiring entity’s business
- The worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed for the hiring entity.
Now is the time for practice owners to look carefully at the nature of your relationship with therapists who work for you – misclassification falls on your shoulders, and I can tell you first hand that Labor and IRS Department audits are not fun, and misclassifications can be very costly in terms of interest and penalties.
Families living within 5 Boroughs of New York City, Long Island and Westchester can benefit from our team of Licensed Behavior Analysts (BCBA) and Behavior Therapists. We are ready to structure a program to address behavior goals, communication training and life skills essential for independence. Parents benefit from guidance and experience in the form of parent training and participation in the therapy. This program comes to you from an agency with 30 years of experience providing therapeutic and educational services across multiple modalities.
We make the process simple:
1. Speak with our team and provide some basic information about your child.
2. Once we verify insurance benefits, parents will need to provide proof of diagnosis and prescription for services.
3. We will obtain authorization from the insurance carrier to assess, develop treatment plan and begin treatment.
We accept most major insurance plans including GHI, UHC, Fidelis Care, NYSHIP, and Oxford. Our team is ready to help verify your benefits, eligibility and check whether you are covered. For some insurance carriers, the service can be provided at no cost.
Dr. Robert Donaldson, DC, PT, OCS, a longtime physical therapist, and his family lost his home in the recent Thomas fire. A GoFundMe account has been set up by his friends – please consider helping out – this man has contributed to our field for decades.
Dr. Robert Donaldson, DC PT OCS and his wife Jacqueline need your help to rebuild their house. Their home of 33 years and everything inside was lost in the Thomas Fire on Dec.4th 2017. Bob has spent decades as a physical therapy helping individual patients and our profession as a whole. This is our opportunity to give back to them. Any donation, big or small, will be incredibly appreciated. The funds are directly deposited into their account. Thank you in advance for your consideration. For details:
Beginning October 31, 2017, New York City employers are prohibited from questioning job applicants on their salary history, with violators facing civil penalties of up to $250,000.
Earlier this year, New York City Mayor Bill de Blasio signed into law a piece of legislation banning all New York City employers from questioning job applicants on their current or prior salary in an effort to combat wage discrimination and inequity based on pay history.
Effective October 31, employers are prohibited from doing the following:
- Requesting salary information from applicants, whether on an application or at any time during the interview process.
- Questioning an applicant’s current or previous employers about their salary history.
- Conducting a search for publicly available records or reports in order to learn an applicant’s salary history.
- Relying on salary history in determining an applicant’s compensation if they become aware of an applicant’s salary history.
It is not an unlawful practice if an applicant voluntarily and without prompting discloses their salary history. The law also permits an employer to inquire into an applicant’s desired salary or salary range.
The New York City Commission on Human Rights is responsible for enforcing the law and may penalize violators up to $125,000 for an unintentional violation, and up to $250,000 for violations that are the result of willful, wanton, or malicious conduct.
All New York employers (private and public) are encouraged to review all application materials and job postings to ensure compliance by October 31, 2017. All employees involved in the hiring process should also be familiar with the law.